Endocrine Abstracts

Introduction: The purpose of this study was to describe the clinical characteristics of patients with macroprolactinoma in a second level Hospital.

Methods: Retrospective data collection of patients diagnosed with macroprolactinoma between 2002 and 2017 at Jerez University Hospital.

Results: Complete Data were obtained from 22 patients. The mean age at diagnosis was 40.32 ± 18.3 years (men: 52.9 ± 14.2, women: 27.7 ± 12.4). 50% men (m) and 50% women (w). Prolactin levels at diagnosis: 856.8 ± 1139 ng/ml (m: 1253.6 ± 1332.3, w: 460 ± 779) and adenoma size at diagnosis: 20.6 ± 12.3 mm (m: 28.8 ± 12.6, w: 12.4 ± 3.2). The most common presenting symptom was hypogonadism/oligomenorrhea: 90.9% (m: 45%, w: 55), followed by headache 40.9% (m: 55.5%, w: 44.4%), galactorrhea 22.7% (w: 100%) and 9.1% with visual impairment at diagnosis. There were significant differences in tumor size at diagnosis (P = 0.0001), in tumor size after treatment (P = 0.050) and in the presence of galactorrhea (P = 0.011) between both sexes. Serum prolactin fell to a nadir of 31.5 ± 53.9 ng/ml and fell within normal limits in 71.4% of cases at 8.2 ± 3.9 months. An average dose of cabergoline of 1.5 ± 1.4 mg/week and bromocriptine of 5 ± 3.5 mg/d was used. Tumor size decrease was observed in 94.7% of patients, with a decrease in largest tumor diameter greater than 5.4 ± 4.7 mm (31.6 ± 34.7 months). One patient required surgery for being resistant to medical treatment. Visual disturbances at diagnosis improved after starting medical treatment. No cases of spinal fluid fistula or pituitary apoplexy were observed.

Conclusions: The response to medical treatment was adequate in the vast majority of patients with macroprolactinoma, without further complications. Diagnosis was made at an earlier age in women and tumor size at diagnosis was smaller in women than in men.